Electroniclaim Tutorial

How to use ElectroniClaim / MediSoft clearinghouse upload procedure
ElectroniClaim Upload Procedure

Upload Procedures (continued)

Now you will see the screen below:

Click "OK".

The program will now ask if you would like to view a verification report. Click on "NO".

Electroniclaim then will attempt a connection to NDC and show the following:

From here, click on "abort’. You will now see the following:

Hit abort again. The program will show transmission error occurred. Don’t be alarmed because this is what we need it to say.

Now that the EMC file has been created, we are going to send the file to the Electroniclaim Solution’s Clearinghouse using HyperTerminal.

First, close your Electroniclaim program and go back to Windows. From Windows click the "Start" button, and then go to "Programs" and then go to "Accessories" and then click on "Hyper Terminal".

Look for the Icon named "HypTrm". Click on this Icon. Now you should see the following:

Type in the name –" Electroniclaim Clearinghouse" as shown above. Hit "OK" and you will see the screen below:

Put our Clearinghouse number (714) 674-7967 in the area code and phone number fields and press "OK".

Now when you hit "OK" you will be prompted to "Dial". Click on dial and you will connect to the clearinghouse.

Now, you will be connected to the BBS. You will immediately be prompted for your username and password. Enter both and hit enter until you reach the following screen:

Now type in "1" and enter for "Submit Claims". See the following screen.

As shown above, type in "1" for production and then "Z" for Zmodem. Now hit enter to begin the transfer.

The BBS screen will show, "start your Zmodem upload now" and then click "Transfer" on the utility bar. You will see the program will prompt you for the file name, hit "browse". You will see something like the screen below (just like in Windows Explorer)

Click on the C drive and locate the Mediwin folder in that drive (your Electroniclaim folder is called Mediwin). You will see there are subdirectories within the Mediwin folders. Click on the Data subdirectory and then click on the EMC subdirectory as shown below:

You should see two files within the EMC directory. The top file is your Electronic Claim File where the entire claims that were listed as "Ready to Send" in the Electroniclaim are now loaded. Remember where this file is located because you will need to move it after we have sent the file. Now click once on the "NDC" file and click "open".

Now you will see the following screen:

Click on send. You will see the computer sending the file. When you go back to the BBS screen the BBS will ask you to confirm that the upload was successful.

Type "O" for Okay. Hit enter two times till you see the words, "Upload Successful".

Congratulations! You have successfully uploaded your claim file. Now hit enter again and exit the system. Before you forget, go into Windows Explorer, find the NDC file that you uploaded, rename the file to the date that you sent the file and move it to a "sent folder" that you need to create. If you are not sure how to do this please give us a call for further assistance.

IMPORTANT

DON’T FORGET, go back to Electroniclaim and change all of the claims that were listed as "Ready to Send" as "Sent". You can do this by going into the claims management screen in Electroniclaim and editing the status of each claim by clicking on "Edit".

This is very important because after you have sent your batches of claims, if you left the status as "Ready to Send", then the same claim will be grouped with your next batch and you would be double billing. Double billing may cause Medicare to investigate your clients for fraud. This will not sit well with your clients, so please be thorough.

On the following business day dial into the BBS to check your email. We will send you a report that will tell you if your claims were accepted as well as a report regarding any rejected claims. Check this report every time you send claims! We do not see your rejected reports, these are sent back to you directly. Therefor, it is very important that you download and check your email after sending a batch of claims and ensure that the email is saved onto your hard drive. This is the only way that you will know why a claim was rejected and obviously important information. These reports are confidential. If you are not receiving your reports then you need to contact our clearinghouse department immediately.

We wish you every success in your future business and look forward to a long-term business relationship with you in the future.

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How to use ElectroniClaim